By Dr. Will Carter | The People’s Doctor
Friday night and Saturday night lights in Mississippi are sacred in many communities. Stadiums fill with hundreds — sometimes thousands — of people cheering, praying, celebrating, and rallying behind young men carrying not only footballs, but often the hopes of entire families and towns.
For a few hours, unity seems possible.
Differences appear smaller. Communities come together around a common goal. Rivalries pause for moments of sportsmanship. The energy is contagious.
Then the stadium lights turn off, and reality remains.
The disparities between predominantly White institutions (PWIs) and Historically Black Colleges and Universities (HBCUs) are not new conversations. They have existed for generations and often reveal themselves through differences in facilities, staffing, recruitment budgets, donor support, athletic resources, and long-term institutional investment.
Simply put, some programs are expected to compete at elite levels with significantly fewer resources.
As a physician and someone who has spent years working in population health among underserved communities, I often think about inequity differently. I think about what inequity costs — not only financially, but physically, mentally, and socially.
Football is arguably one of the most dangerous sports there is. Every snap carries risk: concussions, orthopedic injuries, chronic pain, long-term disability, and repetitive trauma with consequences we may not fully understand for years.
All athletes assume risk when they step onto the field, yet we rarely ask whether the systems surrounding them value their long-term health equally.
Who has access to advanced sports medicine programs? Comprehensive rehabilitation services? Mental health support? Nutrition specialists? Recovery technologies? Larger healthcare networks? Long-term alumni relationships capable of opening doors after football ends?
Those differences matter.
Because inequities rarely remain confined to budgets or facilities. Over time, they become embedded within opportunities, environments, chronic stress exposures, and ultimately, health outcomes.
Public health has long recognized that where people live, learn, work, worship, and age can influence health as much as biology itself. Educational opportunities, income, neighborhood conditions, access to care, and structural barriers often predict outcomes long before disease develops.
The same systems influencing opportunity may also influence health.
The blatant racism and division that continue to exist in these United — yet often divided — States of America are not simply moral failures. They are public health concerns.
Chronic exposure to racism, discrimination, and structural inequities activates prolonged stress responses within the body. Cortisol remains elevated. Blood pressure rises. Sleep suffers. Inflammation persists. Over time, these physiologic responses sit at the intersection of hypertension, cardiovascular disease, stroke, diabetes, anxiety, depression, immune dysfunction, and premature mortality.
The body keeps score, but so do communities.
Communities carry cumulative burdens from generations of underinvestment, unequal opportunity, limited healthcare access, and policies that often fail to align with the needs of vulnerable populations. Eventually, those burdens become visible through disparities in life expectancy, maternal mortality, chronic disease prevalence, educational attainment, and economic mobility.
However, racism may also harm those perpetuating it. Sustained anger, fear, hostility, prejudice, and chronic “othering” of people can create persistent psychological stress responses of their own. Although the pathways may differ, prolonged exposure to division and adversarial thinking can negatively influence mental well-being, cardiovascular health, social connectedness, and community trust.
Division is expensive — not only economically, but biologically.
When communities normalize inequity, everyone pays in some way. Some pay through unequal opportunities and poorer outcomes; others pay through fractured trust, chronic stress, fear, and the erosion of collective well-being.
Perhaps one of Mississippi’s greatest paradoxes is that every fall, we demonstrate our ability to unite around football. Thousands gather regardless of background to support young athletes pursuing education, opportunity, and dreams larger than themselves.
If we can create unity inside a stadium for four quarters, why is it so difficult to sustain that same commitment toward equitable investment in education, healthcare, and institutions serving historically marginalized communities?
Because health equity was never solely about hospitals. It has always been about opportunity.
And opportunity — or the absence of it — often determines who thrives long after the cheering stops.
The stadium lights eventually turn off. The question is whether our commitment to equity turns off with them.
Stay well,
Dr. Will
Disclaimer: This column is intended for educational and informational purposes only and does not constitute medical advice, diagnosis, or treatment. Readers should consult their personal physician or qualified healthcare provider regarding individual medical concerns.
